Medical Credentialing & Provider Enrollment

Medical Credentialing Service

                  Apple Billing and Credentialing provides comprehensive medical credentialing for all healthcare providers who are eligible for credentialing with Medicare, Medicaid or commercial insurance carriers. The health care provider will have a dedicated medical credentialing coordinator who will ensure that all necessary documentation is collected and processed in accordance with each payer. The medical credentialing enables healthcare providers to utilize the patient’s insurance to pay for medical services performed. Hence it is important for healthcare providers to credentialed with most payers depending upon the geographical area. Failing to medical credential results in losing patients to other healthcare providers.

Medical Billing Services

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Provider Enrollment

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Here are the information needed

  1. CAQH Proview
  2. Medical license
  3. DEA certificate
  4. Malpractice insurance certificate
  5. Board certifications
  6. Updated CV with all educational and work history details
  7. W9
  8. PECOS

Provider Credentialing

  1. Gathering credential documents
  2. Credential documents verification
  3. Suggest to update or how to obtain certain missing documents
  4. Payer application evaluation
  5. Application submission to payers
  6. Follow up with payers until the applications are approved
  7. Maintain provider data and CAQH profile

Credentialing Status 

  1. Weekly Status reports credentialing process
  2. Dedicated credentialing coordinator to assist  throughout the process
  3. Prior notifications of expired malpractice insurance, licenses, DEA, Board Certification etc
  4. Prior notification on hospital and  facility re-credentialing.
Medical Billing & Credentialing